皮肤栅栏状包囊性神经瘤

报告1例表现为面部结节的皮肤栅栏状包囊性神经瘤.患儿男,10岁.下颏部淡红色无痛性丘疹、结节半年就诊.根据临床和组织病理改变诊断为皮肤栅栏状包囊性神经瘤.该病诊断主要依靠特异性的组织病理改变.     

棘状秃发性毛发角化病

报告1例棘状秃发性毛发角化病.患者男,22岁.因头皮弥漫性毛囊角化性丘疹伴脱发10余年就诊.皮肤科检查:头皮弥漫性瘢痕性脱发和毛囊角化性丘疹,并可见散在分布细小和稀疏的头发.组织病理检查可见表皮毛囊角化过度和轻度的毛囊周围纤维化,毛囊和血管周围有少量慢性炎性细胞浸润.结合临床和组织病理检查,符合棘状秃发性毛发角化病的诊断.临床上,该病需与棘状秃发性毛囊炎、毛囊性鱼鳞病伴脱发和畏光综合征(IFAP)、角膜炎-鱼鳞病-耳聋综合征(KID综合征)和无萎缩脱毛性毛发角化病等病鉴别.     

冰黄肤乐软膏治疗寻常性银屑病临床疗效观察

我们于2007年8-10月对西藏芝芝药业生产的冰黄肤乐软膏治疗寻常性银屑病的临床疗效和安全性进行评价. 一、对象 1.入选标准:132例寻常性银屑病患者均为皮肤科门诊患者,男女不限,均处于静止期,病程长,皮损较局限,呈斑块状或货币状,暗红,浸润明显,经久不退.     

栅栏状有包膜神经瘤6例临床及病理分析

目的分析栅栏状有包膜神经瘤临床和组织病理特点。方法对我科诊断的6例栅栏状有包膜神经瘤临床和组织病理资料进行系统性回顾分析。结果栅栏状有包膜神经瘤临床表现为孤立性肤色丘疹。组织病理学表现为真皮内界限清楚的以施旺细胞束增生为主的良性肿瘤,肿瘤组织间伴有明显裂隙,瘤细胞无异形性。免疫组化检查肿瘤细胞S-100蛋白阳性,神经束膜细胞EMA阳性。讨论栅栏状有包膜神经瘤临床表现无特异性,临床症状的多样性造成临床诊断困难,组织病理学和免疫组化检查为本病确诊提供主要依据。     

苔藓样念珠状疹1例

苔藓样念珠状疹是一种很少见的泛发性慢性炎症性丘疹性皮肤病,现将我们所见1例报道如下. 临床资料 患者女,36岁.胸、腹部扁平丘疹伴瘙痒20余年,呈念珠状泛发全身10余年,2005年6月来我科就诊.     

活血化瘀法治疗银屑病疗效与血液流变学变化的关系

银屑病治疗较为棘手,尤其是寻常性静止期斑块状银屑病顽固难愈.笔者采用活血化瘀方法治疗90例寻常性银屑病患者,同时在治疗前、后进行血液流变学指标的检测,探讨其治疗效果与血液流变学变化之间的关系,以期为临床应用传统治疗方法提供现代医学的理论依据.     

栅状有包膜神经瘤一例

摘要：报道一例栅状有包膜神经瘤,患者女,34岁,上唇皮疹5年。根据临床和组织病理改变诊断为皮肤栅状包囊性神经瘤。     

Siemens大疱性鱼鳞病1例临床特征及基因突变分析

目的 报告1例散发的Siemens大疱性鱼鳞病的临床特征及KRT2基因突变情况。方法 收集患者临床资料,并对其进行皮损组织病理、直接免疫荧光等检查;采集患者及其父母外周血进行基因测序,选取100例无亲缘关系的健康人作为对照,分析可疑致病位点。结果 患者自幼发病,皮损表现为躯干及四肢角化过度伴鳞屑,脐周、双膝关节及踝关节处有深棕色波纹状角化,局部可见典型“蜕皮”现象,周围呈领圈状脱屑,不伴掌跖角化。下腹部可见簇集性小脓疱。腹部脓疱行组织病理示：表皮网篮状角化过度,角质层下水疱形成,内含中性粒细胞及渗出物。脓疱的细菌培养呈阴性。直接免疫荧光示：IgA、IgG、C3均阴性。患者KRT2基因存在杂合错义突变c.1459G>A(p.E487K),而患者父母此位点未发现突变。结论 该患者诊断为Siemens大疱性鱼鳞病,其临床表型由KRT2基因c.1459G>A(p.E487K)杂合突变所致。     

非感染性肉芽肿

971104 穿通性环状肉芽肿2例/吕玲…∥临床皮肤科杂志,-1996,25(3).-171均为丘疹型,1例临床应损类似寻常疣.组织病理示真皮上部栅状肉芽肿和穿通管道,从表皮排出真皮内变性物质.电镜观察见大量组织细胞、变性的胶原纤维和弹力纤维,坏死区组织细胞呈现变性,未见吞噬弹力纤维,但在其周围见变性弹力纤维与质膜密切接触.参5(原文摘要)971105 进行性慢性盘状肉芽肿病一例/陈明华…∥     

角化性皮肤病

20060848播散性表浅性光化性汗孔角化症1例/张大维(四川大学华西医院皮肤科),黄俊,王琳…∥临床皮肤科杂志.-2005,34(10).-691女,38岁。颜面部、四肢多数角化性环形浅褐色皮损20年。检查:双面颊可见米粒至扁豆大灰褐色或棕褐色角化性斑疹,呈环形或不规则环形,中央略萎缩凹陷,周围呈角化性锯齿状堤状隆起,质硬,表面粗糙。鼻梁部数个皮损融合呈地图状。四肢运端散在数个类似皮损。组织病理检查:汗孔周边堤状隆起处组织病理改变为角化过度和棘细胞肥大,堤顶有裂沟,沟内有大的角质栓,其下颗粒层消失。图1(刘艳)20060849播散性浅表性光化性汗孔角…     

EVALUATION OF CURETTAGE AND ELECTRODESICCATION IN TREATMENT OF KERATOACANTHOMA

The reports from all keratoacanthoma curettings which were submitted to a Brisbane pathology practice over a two year period were reviewed. Those followed up for less than 12 months were not included in the analysis, unless recurrence occurred. Of 150 submitted, 111 keratoacanthomas in 106 patients could be studied. The sex distribution was almost equal, and the mean age of patients was 65 years for females and 64 years for males. Four keratoacanthomas recurred over periods ranging from 3 to 26 months. Curettage and electrodesiccation is shown to be an efficient and effective form of therapy.     

DETECTION OF SCLERODERMA WITH CAPILLAROSCOPIC ABNORMALITIES OF NAILFOLDS

Background. Systemic scleroderma is a problem in Gifu Prefecture, Japan. Methods. Three hundred and thirty-two men and 731 women over 30 years of age, who attended the residents’health examination in K town of Gifu Prefecture (population 4835 persons over 30 years of age) had a dermatologic examination. Antinuclear antibody was determined in 85 persons (14 men, 71 women; age 30 to 72 years) who had Raynaud's phenomenon or various clinical features related to systemic scleroderma. Of these 85 persons, 19 agreed to a capillaroscopic examination and of these, 16 showed some capillaroscopic abnormalities. Biopsy specimens of three women among these 16 individuals with capillaroscopic abnormalities were examined also histopathologically. Results. All samples taken from the forearm skins showed thick and packed bundles of collagen with hyalinization and thickened small blood vessels in the dermis, similar to histopathologic features of systemic scleroderma, although all these women had only a sausage-like swelling of the fingers and a shortened frenulum of the tongue. These results suggest that the prevalence of systemic scleroderma can be estimated to affect more than 0.38% of the population in this town. Conclusions. Manual skills and vibration exposure may be associated with systemic scleroderma.     

LETTER-SIWE DISEASE REPORT OF SIX CASE

SUMMARY.— Six cases of Letterer-Siwe disease occurring in a population of 1,500,000 over a period of 10 years are described. Five have died and 1 survives 2 years after cessation of therapy and 4 years after diagnosis. Of those who died, in 2 the terminal event was measles infection, in 1 surgical emphysema consequent on rupture of a lung cyst and in 2 death followed progression of the disease.     

AGE AND GENDER DIFFERENCES IN THE IMPACT OF PSORIASIS ON QUALITY OF LIFE

Background. The impact of psoriasis upon the quality of life contributes significantly to the overall morbidity associated with the disease. An older age at onset of psoriasis and being a man have been associated previously with lower psychosocial morbidity. In order to further evaluate these potentially important mitigating factors, we examined the relation of age and gender on some aspects of psoriasis-related psychosocial morbidity. Methods. Two hundred and fifteen consenting psoriasis patients, representing a wide range of disease severity, were studied. They included 110 men and 105 women, age range 19–87 years (age: mean ± SD: 48·0 ± 15·9 years); all endorsed a list of 30 items (by checking a “Yes” or “No”) pertaining to life events related to psoriasis that they had experienced in the previous one month. The patients self-rated the severity of their psoriasis. The patients were categorized into four age groups of 18–29 years (N = 28), 30–45 years (N = 77), 46–65 years (N = 76), and > 65 years (N = 34), respectively, for the statistical analyses. Results. No age or gender differences in the severity of psoriasis were observed. Patients of both sexes in the 18 to 29 and 30 to 45 year age groups reported more frequent (P 0·05) problems related to both appearance/socialization and occupation/finances, in contrast to patients in the 46–65 and over-65-year age groups. No gender differences (P 0·05) were observed in the frequency of items related to appearance and socialization; however, men reported greater work-related stresses. Conclusion. Psoriasis has a greater impact upon the quality of life of patients in the 18 to 45 year age range and affects the socialization of both sexes equally. Men face greater work-related stresses as a result of their psoriasis.     

CURATIVE EFFECT OF DEXAMETHASONE-CYCLOPHOSPHAMIDE PULSE THERAPY FOR THE TREATMENT OF PEMPHIGUS VULGARIS

In 1982, five patients having pemphigus vulgaris, four men and one woman, ranging in age between 16 and 48 years, were treated with an arbitrary regimen designed by us. The regimen consisted of giving 100 mg dexamethasone in 500 mL of 5% glucose by a slow intravenous infusion on three consecutive days, along with 500 mg cyclophosphamide on one day only. Such dexamethasone-cyclophosphamide pulses (DCP) were meant to be given once a month, but most patients were not regular in this treatment. In between these pulses the patients received only 50 mg cyclophosphamide orally per day. Oral corticosteroids were given only when necessary. After having received a total of 14 to 48 DCPS, further treatment for pemphigus was withdrawn. All the patients are in continuous clinical remission for the last 4 to 9 years and without any treatment for 2 to 7 years. Further studies on more pemphigus patients have yielded similar results suggesting that it may be possible to cure pemphigus.     

CLINICAL STUDY OF POROKERATOSIS: REPORTS OF 10 CASES

Morphological and histopathological observations made over 4 years of 10 patients with porokeratosis are described. Absence of familial involvement was notable. Association of porokeratosis with tinea cruris, leprosy and epithelioma was seen, and their possible correlation is discussed.     

DAPSONE AND SULFAPYRIDINE THERAPY OF PEMPHIGOID DISEASES

Since 1974, dapsone and sulfapyridine have been used to treat 30 patients with localized oral pemphigoid, 36 with cicatricial pemphigoid, and 11 with cicatricial pemphigoid limited to the eyes; 7 of these 77 patients were less than 50 years of age. Follow-up was J to 12 years (mean, 4.8 years). Of the 30 patients with localized oral pemphigoid, half were in remission and off treatment at a mean follow-up of 5 years. Of 25 patients with cicatricial pemphigoid who received dapsone therapy as initial treatment, 15 (60%) had a successful result. Sulfapyridine was successful in three patients and dapsone in six additional patients after other therapy. Thus, dapsone or sulfapyridine therapy was successful in 24 of 34 patients (71%). In 30 patients with pemphigoid limited to the ocular mueosa or cicatricial pemphigoid with ocular manifestations, 25 (83%) responded successfully to dapsone or sulfapyridine; there were no treatment failures among these 30 patients with ocular pemphigoid. Overall, of the 77 patients, of 55 who underwent an evaluable eotirse of dapsone or sulfapyridine therapy, 47 (85%) responded successfully.     

TREATMENT OF PITYRIASIS RUBRA PILARIS WITH AZATHIOPRINE

Summary.— Treatment with azathioprine has been used successfully in 5 cases of widespread PRP. Four cases cleared completely and in the other, after good improvement, treatment was abandoned on account of abdominal pains. Complete clearing may be slow, and treatment needs to be long continued. Two cases remain clear without treatment after 3 years and 2 years respectively. No serious side-effects have been seen with the doses used.     

STUDY OF ROLE OF STREPTOCOCCAL THROAT INFECTION IN PITYRIASIS ROSEA

Background:

Pityriasis rosea is a common, acute exanthem of uncertain etiology. The exact cause of pityriasis rosea is not known but various hypotheses have been postulated incriminating infective agents such as viruses, bacteria, spirochete and noninfective etiologies such as atopy and autoimmune causes have also been investigated.

Aim:

We undertook a study to investigate the role of Streptococcus haemolyticus in the causation of pityriasis rosea and study the levels of C-reactive protein (CRP) and ASLO titer in patients with pityriasis rosea.

Materials and Methods:

The study included 20 patients with pityriasis rosea attending the outpatient dermatology department at JIPMER hospital during the period from June to December 2004. Corresponding number of age- and sex-matched controls were chosen from amongst healthy individuals and patients attending skin OPD with dermatological disorders other than pityriasis rosea.

Results:

On analyzing the data collected from 20 cases of pityriasis rosea, the average age was found to be 15.3 years and ranged from 5 years to 30 years. The male to female ratio was found to be 1.5:1. The average duration of illness was 14.5 days (median) and 29.3 days (mean). CRP was negative in all the cases as well as the controls. ASLO titer was found to be raised in 2 (10%) cases, while it remained below the critical value in all the controls. On comparing the cases and controls, the raised ASLO titer in the cases was found to be not statistically significant (p = 0.147). From the throat swab culture, Streptococcus haemolyticus was isolated from only one case and none of the controls. This finding was not statistically significant (p = 0.310).

Conclusion:

As per the findings of the present study, we arrived at conclusion that there is no association between streptococcus pharyngitis and pityriasis rosea.     

AN INTERROGATIVE STUDY OF PATTERN OF URTICARIA IN CHILDREN

Of the 44 patients of urticaria in children in 52.3 percent, the etiologic agents were defined with food as the major cause. The clinical features were characterized by itching, erythema, wheals and oedema of different configuration. The urticaria lesions were commonly seen on the extremities and the trunk. Largely the patients applied for treatment in the course of a week. Majority of the patients were in the age group of 5–9 years. The acute urticaria was most frequent, while the other variants were rare. The laboratory investigations were largely equivocal. The parasitic infestations in particular as etiologic factors were inconclusive.